title: Long versus short axis ultrasound guided approach for internal jugular vein cannulation: a prospective randomised controlled trial.
abstract: OBJECTIVE
  The aim of this study was to compare the short and long axis approaches to ultrasound guided right internal jugular vein cannulation with respect to indicators of success.
  
  
  METHODS
  Patients undergoing cardiac surgery requiring central venous cannulation (99 patients) were randomised to undergo either long or short axis ultrasound guided cannulation of the right internal jugular vein by a skilled anaesthetist. First pass success, number of needle passes, procedural taken and complications were documented for each procedure.
  
  
  RESULTS
  The right internal jugular vein was successfully cannulated in all 99 patients. The first pass success rate was significantly higher in the short axis 98% group compared to the long axis group 78% [48:1 (98%) versus 39:11 (78%) p <0.006]. Procedural time was comparable in both the groups [39.6 (18.4) versus 46.9 (42.4)]. Fewer needle redirections were required in the short axis group [1.02 (0.02) versus 1.24 (0.56) p <0.004]. Carotid artery puncture only occurred in the long axis group.
  
  
  CONCLUSIONS
  We conclude that anaesthetists with experience in ultrasound guided internal jugular vein cannulation, have higher first pass success rate and less carotid artery puncture when a short axis, rather than a long axis, approach is employed.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, Wilton Road, Cork, Ireland.
authors.forename: Suresh
authors.initials: S
authors.lastname: Chittoodan
authors.forename: Dorothy
authors.initials: D
authors.lastname: Breen
authors.forename: Brian D
authors.initials: BD
authors.lastname: O'Donnell
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Iohom
mesh_terms: D002404:Catheterization / Q000379:methods*; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*